Gabapentin vs Lyrica: gabapentin and pregabalin compared

At a glance

• Approved pain uses

  Gabapentin

  Nerve pain after shingles

  Lyrica

  Nerve pain from diabetes, shingles and spinal cord injury, and fibromyalgia

• Other approved use

  Gabapentin

  Add-on treatment for partial seizures

  Lyrica

  Add-on treatment for partial seizures

• Absorption

  Gabapentin

  Less predictable at higher doses, usually taken three times a day

  Lyrica

  Predictable and dose-proportional, two or three times a day

• Controlled substance

  Gabapentin

  Not federally, but Schedule V in several states

  Lyrica

  Federal Schedule V

• Generic available

  Gabapentin

  Yes

  Lyrica

  Yes

How they compare in practice

Both calm overactive nerve signaling and share side effects: dizziness, sleepiness, swelling of the ankles and weight gain. Because pregabalin is absorbed more reliably, its effective dose is reached faster and more predictably, while gabapentin is often increased gradually over weeks. Many people who do not respond to one are tried on the other.

Safety

The FDA has warned that both can cause serious breathing problems in people who also take opioids or other sedatives, or who have lung disease, and in older adults. Both can be misused, which is why pregabalin is federally controlled and several states schedule gabapentin. Neither should be stopped suddenly after regular use.

Cost and filling

Both are available as generics, and each pharmacy sets its own cash price, so compare quotes for your exact strength and quantity. Where a drug is a controlled substance, refills are limited and transfers restricted, and gabapentin’s status depends on the state, as our state guides set out.

Who might get one rather than the other

Gabapentin’s FDA-approved pain use is nerve pain after shingles; prescribers also use it for other kinds of nerve pain, which are not FDA-approved uses, and the prescriber decides whether that suits you. Pregabalin is often chosen when its approved uses match, such as nerve pain from diabetes or fibromyalgia, or when gabapentin’s uneven absorption makes dosing difficult. Doses of both are lowered when kidney function is reduced.

Read more

• Gabapentin guide
• Lyrica guide
• Gabapentin rules in every state
• Nerve pain medications
• Pharmacy rules by state